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MOON RIVER, LLC
NPI 1730143553
Behavior Analyst in Marietta, GA

Active since April 17, 2006
790 OAK TRAIL DR, MARIETTA, GA 30062(770) 977-6866(770) 977-6887 Get Directions Write a Review

NPPES record last updated: February 18, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 18, 2025, Feb 15, 2017 (2 updates tracked since 2017).

About Moon River, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOON RIVER, LLC (NPI 1730143553) is a healthcare organization registered as a behavior analyst in Marietta, Georgia and active in the NPI registry since April 2006. The organization lists Laura Desantis, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1730143553
Entity TypeOrganization
Primary Taxonomy103K00000X
Legal Business NameMOON RIVER, LLC
Location Address790 OAK TRAIL DRMarietta, GA 30062-7502
Mailing Address790 Oak Trail DrMarietta, GA 30062-7502 · (770) 212-2170 · Fax (770) 783-8639
Phone(770) 977-6866
Fax(770) 977-6887
Organization SubpartNo
Authorized OfficialLaura DesantisOffice Manager · (770) 212-2170
Enumeration DateApril 17, 2006
Last NPPES UpdateFebruary 18, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 18, 2025
✔ NPI 1730143553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers
Taxonomy Code103K00000X
Definition
A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.
Also ListedPsychologistTaxonomy 103T00000X
Also ListedPhysical TherapistTaxonomy 225100000X · License PT003833 (GA)
Also ListedOccupational Therapist · PediatricsTaxonomy 225XP0200X · License OT 004293 (GA), GAOT001717 (GA)
Also ListedSpeech-Language PathologistTaxonomy 235Z00000X · License SLP003992 (GA), SLP005806 (GA), SLP006528 (GA), SLP 06551 (GA), SLP 006556 (GA)
790 OAK TRAIL DR, Marietta, GA 30062
Open in Google Maps ↗

Other Identifiers 20

Medicaid000970835AGA
Medicaid317872221AGA
Medicaid503885675BGA
Medicaid315889908AGA
Medicaid339518223AGA
Medicaid516643175AGA
Medicaid761415888AGA
Medicaid765677599AGA
Medicaid814363142AGA
Medicaid188883028BGA
Medicaid426315361AGA
Medicaid000753563EGA
Medicaid191707573AGA
Medicaid461168837AGA
Medicaid481436178BGA
Medicaid000860736BGA
Medicaid240960806AGA
Medicaid850524466AGA
Medicaid146855825AGA
Medicaid986209149BGA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MARIE DIAZ
Case Manager/Care Coordinator
790 OAK TRAIL DR
MARIETTA, GA 30062
Cobb County (770) 977-6866
LUKECIA T. GRAYSON
Social Worker
790 OAK TRAIL DR
MARIETTA, GA 30062
Cobb County (770) 977-6866
MS. SAMER SATURION CLARK PT
Physical Therapist
790 OAK TRAIL DR
MARIETTA, GA 30062
Cobb County (770) 977-6866
DONNA TANEDO PT
Physical Therapist
790 OAK TRAIL DR
MARIETTA, GA 30062
Cobb County (770) 212-2170
MS. BARBARA T COOPER
Case Manager/Care Coordinator
790 OAK TRAIL DR
MARIETTA, GA 30062
Cobb County (770) 977-6866
MS. JANETTE BROWN
Case Manager/Care Coordinator
790 OAK TRAIL DR
MARIETTA, GA 30062
Cobb County (770) 977-6866
LATOYA ROBERTS SLP
Speech-Language Pathologist
790 OAK TRAIL DR
MARIETTA, GA 30062
Cobb County (770) 977-6866
EMMALYN BHENDE
Occupational Therapist (Pediatrics)
790 OAK TRAIL DR
MARIETTA, GA 30062
Cobb County (770) 977-6866

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Moon River, LLC's NPI number?

The NPI number for Moon River, LLC is 1730143553. It was assigned to this organization in the NPPES registry on April 17, 2006.

Where is Moon River, LLC located?

Moon River, LLC is located at 790 Oak Trail Dr, Marietta, GA 30062. The listed phone number is (770) 977-6866.

What is Moon River, LLC's specialty?

The primary specialty registered for this NPI is Behavior Analyst with taxonomy code 103K00000X.

What insurance does Moon River, LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Moon River, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Moon River, LLC was last updated on February 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.